Topical tacrolimus 0.03% monotherapy for vernal keratoconjunctivitis—case series

2 Tacrolimus is more potent than cyclosporine. 3 Dermatological preparations (Protopic ointment, Astellas Phama, Tokyo, Japan) are FDA-proven for the treatment of atopic dermatitis. Age (years) 10 12 10 8 21 Duration of VKC (years) 2 1.5 1 0.25 12 Conjunctival signs Giant papillae, hyperaemia, mucoid discharge Giant papillae, mucoid discharge Giant papillae, hyperaemia Giant papillae, mucoid discharge, hyperaemia Chronic giant papillae, hyperaemia Corneal signs Pannus, Shield ulcer PEE Epithelial defect, PEE Filamentary changes, PEE Pannus, scar Ocular complications from past Nil Nil Nil Nil Steroid induced cataracts & glaucoma, GDD OU Atopic associations Rhinitis Eczema Rhinitis Nil Eczema Eczema Previous topical treatment Autologous serum MCTT PF, FML AH Lubricants MCTT FML Lubricants MCTT AH PF Lubricants AH FML Lubricants CSA 0.05% MCTT PF, FML AH Lubricants Pre-treatment VA 20/30 OD 20/100 OS 20/30 OU 20/100 20/50 OU 20/30 OD 20/100 OS Final VA 20/20 OD 20/100 OS 20/30 OU 20/30 20/20 OU 20/30 OD 20/70 OS Sequelae Central corneal scar Nil Nil Nil Symptom-free papillae Total duration of tx (months) 5 1.5 4 1 4 MCTT, mast cell targeted therapy; AH, antihistamines; PF, pred forte; FML, fluorometholone; CSA, cyclosporine.